Understanding Cancer Therapy and Cognitive Changes

Survival rates for most cancers are climbing, but a cancer diagnosis still carries an enormous impact for patients and their loved ones. Adding to the difficulty, patients often experience many unpleasant symptoms during or after their treatment.

Common reactions of chemotherapy and radiation include hair loss, nausea and fatigue, among others. Changes in memory and thinking are some side effects that can be especially unnerving.

Two experts at the University of Cincinnati are working to spread awareness and find solutions for patients suffering from cognitive impairment: William Barrett, MD, director of the University of Cincinnati Cancer Institute and chair and professor of UC’s Department of Radiation Oncology, and Joseph Broderick, MD, director of the University of Cincinnati Gardner Neuroscience Institute and professor in UC’s Department of Neurology and Rehabilitation Medicine. 

"The brain is involved in all cancers in some way," says Dr. Broderick. "We’re trying to find out how to minimize the effects of therapy, the effect of the cancer and how to maximize the well-being of patients." 

Cognitive changes can occur from radiation treatments and chemotherapy. Shifts in memory due to radiation usually occur as late side effects – anywhere from six months to two years after the treatment. Side effects from chemotherapy (often referred to as "chemo brain") occur during therapy, but usually clear up a few months after treatment. 

Common changes include a reduction in mental sharpness – trouble concentrating, remembering details or having difficulty finishing tasks. It’s challenging for doctors to pinpoint brain problems, especially since patients often don’t mention their symptoms until their everyday lives are significantly hindered. 

Pediatric patients are strikingly prone to experiencing treatment injury, whether from chemotherapy or radiation therapy. For example, a child who has leukemia and whose brain and spinal cord is treated by radiation to eliminate potential leukemia cells can have changes in brain cell function and decreased ability to make new brain cells.

"The effects of radiation on the brain and spinal cord can have substantial impact on the thinking and development of the child down the line," says Dr. Broderick. "We’re researching how to minimize those effects and determine when patients actually require the treatment and when they shouldn’t." 

Although children are more susceptible to treatment side effects, pediatric cancer patients are also extremely resilient. "Their ability to recover and regenerate is

immense – children have more sensitivity, but on the other hand better recovery," says Dr. Barrett.     

In 2015, the UC Cancer Institute and the UC Gardner Neuroscience Institute partnered to offer the first patient symposium on the effects of cancer and cancer treatment on memory and thinking. Given the tremendous interest in the subject matter, UC Health will offer the free symposium again on September 24, 2016. The event will be held at the Kingsgate Marriott between 8:30 a.m. and 12:30 p.m. Those interested in attending the symposium, which is free of charge, are asked to register by visiting www.uchealth.com/events/cancermemory. 

"We had a large turnout of patients and particularly the loved ones of patients who were interested," says Dr. Barrett. "The purpose was to educate people about the potential effects and to offer strategies that can be helpful and mitigate those effects." 

Suggestions included memory exercises, sleep patterns, physical exercise, medications and more. Cognitive changes are a complex issue, and one the doctors hope to understand better as more research is conducted. 

"The collaborative spirit of the University of Cincinnati and throughout this city is exceptional," says Dr. Barrett. "We want cancer care to be a community-wide effort; once a patient gets a diagnosis and has to face this adversary, we want to be the place for them to receive the best possible outcome."

For more information about the UC Cancer Institute, call 513.475.8000 or visit www.UCHealth.com/cancer. 

For more information about the UC Gardner Neuroscience Institute, call 513.475.8000 or visit www.UCHealth.com/neuro.